The Special Enrollment Period, Qualifying Life Events, and changes to income are VERY date sensitive. It can also be a little confusing in terms of what dates to use. If you don’t enter the correct dates, such as when income stopped or started, the application process can go sideways and you might be determined eligible for Medi-Cal. When in doubt, call your agent or the Covered California customer service line to determine the correct dates for your qualifying life event.
Search Results for: covered california
Special_Enrollment_Period_App_Steps Covered California 2019.pdf (735.81 KB)
FAQ Special Enrollment Covered California 2019.pdf (320.82 KB)
Covered California Enrollment Decline Not Solely Based On Individual Mandate
The cost of the individual mandate is nothing compared to the cost of a decent health insurance plan. People are not enrolling in health insurance because it is too damn expensive. I don’t know what percentage of the decline in new enrollments for Covered California is due to expensive health insurance and they don’t know either. Talk to any health insurance agent they will tell you they fielded many calls from consumers wanting a lower rate on health insurance. They were willing to take anything, even if crappiest of plans if they could just afford it. I don’t sell them, but I had to inform people of the health care sharing ministries. These health care sharing plans are not insurance, but they can seem like a health plan for half the cost of a Covered California plan. How many people enrolled in these health care sharing plans and by-passed Covered California and the off-exchange plans altogether?
Covered California Premiums Higher Than Small Group Rates
The first comparison was of two individuals at a Sacramento company enrolled in a Sutter small group HMO Silver plan. The rate for the 60-year-old employee is $838 and $688 for the 56-year-old employee. An IFP Silver plan directly from Sutter Health Plus HMO is $1,115 for the 60-year-old and $958 for the 56-year-old. The IFP rate is 25% and 28% higher than the small group plan at the respective ages. The lowest IFP plan available to these employees in the Sacramento region is a Kaiser Silver HMO plan at $990 for age 60 and $851 for age 56.
Explaining Medi-Cal & Covered California Federal Poverty Level Income Amounts
Where a primary source of confusion starts to creep into the preliminary eligibility determination for either Medi-Cal or Covered California hinges on when the new FPL amounts are considered for eligibility. This is where the rules concerning determining eligibility are not necessarily aligned between Medi-Cal and Covered California. The rules put forth by the ACA govern how Covered California applies the FPL amounts for determining eligibility for the Premium Tax Credit subsidy, which are slightly different than Medi-Cal. The Department of Health Care Services, the agency that administers Medi-Cal, must abide by older federal rules for eligibility determinations.
New Adjusted Gross Income Federal Income Tax Line For Covered California Income Estimates
Basically, the redesigned 2018 form 1040 has made it more difficult to quickly locate all the necessary information for estimating a household’s MAGI. Virtually all of the dollar amounts were listed on the first page of the old form 1040. Now Covered California participants will have to review page 2 of the 1040 and Schedule 1 income and deductions to get most of the information for their estimated MAGI.
Medi_Cal_Subsidy_FPL_Webinar_Slides_Covered California 2018.pdf (538.41 KB)
Medi_Cal_Subsidy_FPL_Webinar_Slides_Covered California 2018.pdf (538.41 KB)
Wrong Subsidy Amount With Covered California Enrollment Groups
Even though the Covered California programs indicated one subsidy amount, a higher amount was actually applied to the first family member’s health insurance premium. It is clear from the displays that Covered California is applying too much APTC. In the first illustration, John was eligible for $272.12 per month, but Covered California applied $377.12.